抗抑郁药联合重复经颅磁刺激治疗卒中后抑郁的meta分析

发布时间：2018-06-22 12:18

本文选题：卒中后抑郁 + 重复经颅磁刺激　；参考：《中国心理卫生杂志》2017年04期

【摘要】：目的:系统评价重复经颅磁刺激(rTMS)联合抗抑郁药对脑卒中后抑郁(PSD)患者的疗效。方法:计算机检索Pubmed、Cochrane library、OVID、中国知网(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊数据库(VIP)、万方数据库(Wanfang Data)所有关于rTMS联合抗抑郁药治疗PSD患者的随机对照试验(RCT),对符合纳入标准的文献用ReVMan 5.3软件对文献数据进行meta分析,统计过程选择加权均数差(WMD)法,比较两种治疗方式对患者疗效的改善是否有统计学意义。结果:共纳入13个RCT研究,共计1033人,将所纳入的文献分为低频及高频分组分析,低频(WMD=-4.24,95%CI:-6.57~-1.92)、高频(WMD=-4.00,95%CI:-4.56~-3.65)干预组的汉密顿抑郁量表(HAMD)评分低于对照组。干预组的美国国立卫生研究院脑卒中量表(NIHSS)(WMD=-2.21,95%CI:-3.04~-1.38)、简易精神状态检查表(MMSE)(WMD=-7.00,95%CI:-7.64~-6.36)及Barthel指数或改良的Barthel指数(BI或MBI)(WMD=-17.49,95%CI:-21.26~-13.72)评分高于对照组。结论:rTMS联合抗抑郁药较单纯使用抗抑郁药可能更有利于改善脑卒中后抑郁患者的抑郁症状,以及提高患者神经功能、认知水平及日常生活能力。
[Abstract]:Aim: to evaluate the efficacy of repeated transcranial magnetic stimulation (rTMS) combined with antidepressants in patients with post stroke depression (PSD). Methods: a computer-based search of Pubmeda Cochrane libraryl OVID, CNKI, CBM, VIP, Wanfang data, all the randomized controlled trials (RCT) of RTMS combined with antidepressants in PSD patients was conducted. ReVMan 5.3 software was used to analyze the literature data by meta. The method of weighted mean difference (WMD) was chosen in the statistical process to compare the improvement of curative effect between the two treatment methods. Results: a total of 1033 subjects were enrolled in 13 RCTs. The literatures were divided into low frequency and high frequency groups. The scores of Hamilton depression scale (Hamd) in the low frequency (WMD-4.2495 CI: -6.57 ~ 1.92) and high frequency (WMD-4.00 ~ 95CI: -4.56 ~ 3.65) intervention groups were lower than those in the control group. The National Institutes of Health Stroke scale (NIHSS) (WMD-2.21), MMSE (WMD-7.00), Barthel Index (BI) or modified Barthel Index (BI or MBI) (WMD-17.49-95 CI: -21.26-13.72) in the intervention group were higher than those in the control group. Conclusion compared with simple antidepressants, the use of antidepressants combined with WRTMS may be more beneficial to the improvement of depressive symptoms, neurologic function, cognitive level and ADL ability of patients with post-stroke depression.
【作者单位】：首都医科大学附属北京天坛医院神经精神与临床心理科国家神经系统疾病临床医学研究中心北京脑重大疾病研究院脑卒中研究所脑血管病转化医学北京重点实验室;
【分类号】：R743.3;R749.4

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